HopeRX, Project Lazarus unite to combat overdoses

At a HopeRX meeting Monday, founder and president of Project Lazarus, Fred Brason II, shares stories of his project's successes in Wilkes County, which in 2007 was third-highest in the nation for prescription overdoses. The death rate from the overdoses has dropped substantially since 2009.

Published: Wednesday, April 30, 2014 at 4:30 a.m.

Last Modified: Wednesday, April 30, 2014 at 12:13 a.m.

Overdose deaths from prescription drugs nationwide have increased more than 300 percent since 1990, spreading from rural Appalachia to the Eastern and Western Seaboards. Prescription drug abuse has ripped apart families from the wealthiest to the poorest, of all shapes and sizes, leaving no demographic unscathed.

In Henderson County, the number of deaths from opioids bobbed around seven to 13 a year from 2007 to 2011, but first responders now estimate that they see about twice that many.

Just west of Winston-Salem in Wilkes County, which has about 70,000 residents, deaths from overdoses soared to third-highest in the nation in 2007. The incidence rate of prescription drug deaths nearly doubled to about 46 deaths per 100,000 population in 2009. In two years, the rate dropped 69 percent with the help of Project Lazarus.

The successful homegrown initiative, which like the Bible story of Lazarus is aiming to bring people back from the brink of death, is spreading to communities statewide. The initiative was brought to a meeting of Henderson County's HopeRX on Monday.

The HopeRX coalition of community stakeholders, who joined hands last year to fight prescription drug abuse, has chosen to model its program on Project Lazarus' wheel of change. The wheel's hub focuses on increasing public awareness of the problem of overdoses; coalition action to coordinate all sectors of the community response; and collecting and evaluating data to ground an approach based on local needs and improve interventions.

Spokes of the wheel involve community education to improve the public's capacity to recognize and avoid the dangers of misuse or abuse of prescription opioids; provider education to support screening and appropriate treatment for mental illness, addiction and pain; hospital emergency department policies to encourage safe prescribing of controlled substances and provide meaningful referrals for chronic pain and addiction; diversion control to reduce the presence of unused medicines in society; support to help patients and caregivers manage chronic pain; harm reduction to help prevent opioid overdose deaths with the antidote, naloxone; and addiction treatment to help find effective treatment for those ready to enter recovery.

HopeRX recently received a $9,000 grant from Project Lazarus to help energize the initiative and its multi-pronged approach in Henderson County, according to HopeRX Executive Director Julie Huneycutt.

Project Lazarus

Project Lazarus founder and President Fred Brason II said members started researching the issue of prescription drug abuse in Wilkes County in 2004 as the number of deaths a year surpassed epidemic levels.

"As we began to dig into the situation we certainly found the issue within our community, and we realized that as we developed this and nobody had any solutions, that we had to fix it ourselves," he said.

The group found that playing the "blame game" wouldn't help.

"This is a public health issue. It's societal. It's cultural. Substance abuse has been with us forever, and this is just another battle within that battle that we need to work with," Brason said.

The goal is to make sure those who need medication get it without any obstacles or stigma, while those who don't need the drugs have somewhere to go for help when their supply is cut off.

"In my thinking when I first heard that, I said, 'Ok, if this is classified as an accident, accidents are preventable,'" he said. "There are certain methods that we can use to make things safer so that there's less accidents and unfortunately, in this category, the accident is permanent for most people."

A face to the numbers

Accidental overdoses seemed to be classified into four categories. Some people overdosed by misusing medications, others by sharing leftover pills with friends and family members who wouldn't have been prescribed the medicine.

Some used the drugs to get high, while others used the drugs to feed a substance use disorder.

Brason said he was "floored" to learn from one lady that she was taking 25 pills a day, until he met someone who was taking 45.

"Now when you're up to that amount, it is no longer to get high. You are doing it for only one reason, to stay out of withdrawal, to feel as normal as possible," he said.

"We realized from the CDC study that for every one death of overdose from prescription medications, there's 10 to get treatment, there's 32 in emergency departments, there's 130 people who abuse or are dependent and there's 825 non-medical users," he said. "So when we're looking at overdose numbers, we have to realize that there's 1,000 people for every one that could be (dying)."

In 2007, 13 deaths were attributed to prescription drug overdoses in Henderson County. In 2011 – the last year on record – it claimed the lives of seven citizens.

"The Centers for Disease Control says that 8 out of 100,000 is an epidemic," Brason said. "Only one year in the last five were you below epidemic status… But for every one, there's the possibility of 1,000."

Project Lazarus delved deep, looking beyond the statistics and into the faces of victims and their grieving families to shed light on the dilemma. They heard stories of families mourning the deaths of addicted teens, a 5-year-old who liked "mommy better when she was on her happy pills." The group learned that the state was spending $98.9 million for opioid abuse hospitalizations.

They created a battle cry to remind the public to "take (medications) correctly, store securely, dispose properly and never share." The group released its messages in fliers at carpool lines, in newspaper articles, in pamphlets at doctor's offices,onbillboards designed by 12th-graders and inserts in church bulletins. Word got around.

"The CDC has determined that medical schools spend about seven to nine hours training students in chronic pain medication," he said, unlike veterinary schools that devote 75 hours to the training.

Project Lazarus provided toolkits to prescribers in managing chronic pain with tips on how to identify addiction issues and where to send people for help. The group has circulated toolkits with overdose antidotes to communities across the state and beyond state lines, and worked with legislators on a law that passed last year to erase liabilities for first responders to use the antidotes.

"If somebody smokes (cigarettes) their entire life three packs a day, what are they at risk of? Cancer. If somebody drinks a fifth (of liquor) every single day, what are they at risk of? Liver disease. Can they walk in and get treatment with their insurance because they have cancer or liver disease? Yes they can, and yet what caused it? An outside substance. Why is it that we can't treat somebody who's doing the heroin or prescription medications the exact same way?" he asked. "Nobody ever decides that they're going to go out and get addicted, but it happens."

Huneycutt said tax-deductible funds raised by the group will be used for the initiative and to educate the community on safe diversion practices. The public can dispose of unwanted pills at a permanent medication drop box available at the Henderson County Sheriff's Office at 375 First Ave., Hendersonville, from 8 a.m. to 5 p.m. Monday through Friday.

The drop box has netted thousands of pounds of pills for disposal. In recent months, at least two churches have joined the cause, collecting more than 80 pounds of medications for disposal, according to Huneycutt.

Donations to HopeRX can be made through the Community Foundation of Henderson County.

<p>Overdose deaths from prescription drugs nationwide have increased more than 300 percent since 1990, spreading from rural Appalachia to the Eastern and Western Seaboards. Prescription drug abuse has ripped apart families from the wealthiest to the poorest, of all shapes and sizes, leaving no demographic unscathed.</p><p>In Henderson County, the number of deaths from opioids bobbed around seven to 13 a year from 2007 to 2011, but first responders now estimate that they see about twice that many.</p><p>Just west of Winston-Salem in Wilkes County, which has about 70,000 residents, deaths from overdoses soared to third-highest in the nation in 2007. The incidence rate of prescription drug deaths nearly doubled to about 46 deaths per 100,000 population in 2009. In two years, the rate dropped 69 percent with the help of Project Lazarus.</p><p>The successful homegrown initiative, which like the Bible story of Lazarus is aiming to bring people back from the brink of death, is spreading to communities statewide. The initiative was brought to a meeting of Henderson County's HopeRX on Monday.</p><p>The HopeRX coalition of community stakeholders, who joined hands last year to fight prescription drug abuse, has chosen to model its program on Project Lazarus' wheel of change. The wheel's hub focuses on increasing public awareness of the problem of overdoses; coalition action to coordinate all sectors of the community response; and collecting and evaluating data to ground an approach based on local needs and improve interventions.</p><p>Spokes of the wheel involve community education to improve the public's capacity to recognize and avoid the dangers of misuse or abuse of prescription opioids; provider education to support screening and appropriate treatment for mental illness, addiction and pain; hospital emergency department policies to encourage safe prescribing of controlled substances and provide meaningful referrals for chronic pain and addiction; diversion control to reduce the presence of unused medicines in society; support to help patients and caregivers manage chronic pain; harm reduction to help prevent opioid overdose deaths with the antidote, naloxone; and addiction treatment to help find effective treatment for those ready to enter recovery.</p><p>HopeRX recently received a $9,000 grant from Project Lazarus to help energize the initiative and its multi-pronged approach in Henderson County, according to HopeRX Executive Director Julie Huneycutt.</p><p><b>Project Lazarus</b></p><p>Project Lazarus founder and President Fred Brason II said members started researching the issue of prescription drug abuse in Wilkes County in 2004 as the number of deaths a year surpassed epidemic levels.</p><p>"As we began to dig into the situation we certainly found the issue within our community, and we realized that as we developed this and nobody had any solutions, that we had to fix it ourselves," he said.</p><p>The group found that playing the "blame game" wouldn't help.</p><p>"This is a public health issue. It's societal. It's cultural. Substance abuse has been with us forever, and this is just another battle within that battle that we need to work with," Brason said.</p><p>The goal is to make sure those who need medication get it without any obstacles or stigma, while those who don't need the drugs have somewhere to go for help when their supply is cut off.</p><p>Brason learned that prescription drug overdoses were listed by health care professionals as "accidental poisonings."</p><p>"In my thinking when I first heard that, I said, 'Ok, if this is classified as an accident, accidents are preventable,'" he said. "There are certain methods that we can use to make things safer so that there's less accidents and unfortunately, in this category, the accident is permanent for most people."</p><p><b>A face to the numbers</b></p><p>Accidental overdoses seemed to be classified into four categories. Some people overdosed by misusing medications, others by sharing leftover pills with friends and family members who wouldn't have been prescribed the medicine.</p><p>Some used the drugs to get high, while others used the drugs to feed a substance use disorder.</p><p>Brason said he was "floored" to learn from one lady that she was taking 25 pills a day, until he met someone who was taking 45.</p><p>"Now when you're up to that amount, it is no longer to get high. You are doing it for only one reason, to stay out of withdrawal, to feel as normal as possible," he said.</p><p>"We realized from the CDC study that for every one death of overdose from prescription medications, there's 10 to get treatment, there's 32 in emergency departments, there's 130 people who abuse or are dependent and there's 825 non-medical users," he said. "So when we're looking at overdose numbers, we have to realize that there's 1,000 people for every one that could be (dying)."</p><p>In 2007, 13 deaths were attributed to prescription drug overdoses in Henderson County. In 2011 – the last year on record – it claimed the lives of seven citizens.</p><p>"The Centers for Disease Control says that 8 out of 100,000 is an epidemic," Brason said. "Only one year in the last five were you below epidemic status… But for every one, there's the possibility of 1,000."</p><p>Project Lazarus delved deep, looking beyond the statistics and into the faces of victims and their grieving families to shed light on the dilemma. They heard stories of families mourning the deaths of addicted teens, a 5-year-old who liked "mommy better when she was on her happy pills." The group learned that the state was spending $98.9 million for opioid abuse hospitalizations.</p><p>They created a battle cry to remind the public to "take (medications) correctly, store securely, dispose properly and never share." The group released its messages in fliers at carpool lines, in newspaper articles, in pamphlets at doctor's offices,onbillboards designed by 12th-graders and inserts in church bulletins. Word got around.</p><p>"The CDC has determined that medical schools spend about seven to nine hours training students in chronic pain medication," he said, unlike veterinary schools that devote 75 hours to the training.</p><p>Project Lazarus provided toolkits to prescribers in managing chronic pain with tips on how to identify addiction issues and where to send people for help. The group has circulated toolkits with overdose antidotes to communities across the state and beyond state lines, and worked with legislators on a law that passed last year to erase liabilities for first responders to use the antidotes.</p><p>The efforts have made a difference in Wilkes County.</p><p>"Nobody can get it (prescription drugs) in Wilkes anymore unless they're bringing it in… It's someplace else," Brason said. "Now we've got to change someplace else. That's why we're doing this statewide."</p><p>"If somebody smokes (cigarettes) their entire life three packs a day, what are they at risk of? Cancer. If somebody drinks a fifth (of liquor) every single day, what are they at risk of? Liver disease. Can they walk in and get treatment with their insurance because they have cancer or liver disease? Yes they can, and yet what caused it? An outside substance. Why is it that we can't treat somebody who's doing the heroin or prescription medications the exact same way?" he asked. "Nobody ever decides that they're going to go out and get addicted, but it happens."</p><p>Huneycutt said tax-deductible funds raised by the group will be used for the initiative and to educate the community on safe diversion practices. The public can dispose of unwanted pills at a permanent medication drop box available at the Henderson County Sheriff's Office at 375 First Ave., Hendersonville, from 8 a.m. to 5 p.m. Monday through Friday.</p><p>The drop box has netted thousands of pounds of pills for disposal. In recent months, at least two churches have joined the cause, collecting more than 80 pounds of medications for disposal, according to Huneycutt.</p><p>Donations to HopeRX can be made through the Community Foundation of Henderson County.</p><p>___</p><p>Reach Weaver at Emily.Weaver@blueridgenow.com or 828-694-7867.</p>